Pediatric EM Morsels
JULY 19, 2024
Previously, we covered Post-Tonsillectomy Hemorrhage and how we hope that “all bleeding eventually stops: ideally, by means that we have imposed rather than by exhaustion of the patient’s RBC resources.” Since the original morsel ( way back in 2012 ), the literature has shown that there are a few extra ingredients that we can add to our morsel recipe when we care for children with post-tonsillectomy hemorrhage.
American Ambulance Association
JULY 23, 2024
To the Editor of The Guardian, On July 21, The Guardian published Jessica Glenza’s “Plan to end exorbitant ‘surprise’ ambulance bills heads to Congress.” The inflammatory title and lack of […] The post What The Guardian Missed About US Ambulance Balance Billing appeared first on American Ambulance Association.
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Emergency Medicine Cases
JULY 8, 2024
In this episode: recognition, risk stratification, decision tools, indications for lumbar puncture in the febrile pediatric patient, tips and trick on performing LPs in children, and ED management of pediatric meningitis. We answer such questions as: what are the test characteristics of the various clinical features of meningitis across various ages?
Core EM
JULY 23, 2024
We discuss an approach to the acutely agitated patient and review medications commonly used. Hosts: Jonathan Kobles, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Agitation , psychiatry , Toxicology Show Notes Background/Epidemiology • Definition and Scope : Agitation encompasses behaviors from restlessness to severe altered mental states.
The Skeptics' Guide to EM
JULY 20, 2024
Reference: Gibbs et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation (The PREOXI trial). NEJM June 2024. Date: July 17, 2024 Guest Skeptic: Dr. Aine Yore is an Emergency Physician, practicing in the Seattle, Washington area for over twenty years. She is the former president of the Washington chapter of ACEP and her career focus outside of clinical practice has been largely devoted to health care policy.
Critical Care Scenarios
JULY 10, 2024
We learn about the training, role, and benefits of hospital chaplains, with Christine V. Davies, MDiv, MSW, Director of Chaplaincy at Robert Wood Johnson University Hospital. Find us on Patreon here! Buy your merch here! We learn about the training, role, and benefits of hospital chaplains, with Christine V. Davies, MDiv, MSW, Director of Chaplaincy at Robert Wood Johnson University Hospital.
Pediatric EM Morsels
JULY 26, 2024
We have discussed many causes of encephalitis and encephalopathy previously (ex, Eastern Equine Encephalitis , Posterior Reversible Encephalopathy , FIRES , Reye’s Syndrome ) and have highlighted the fact that they can be challenging to diagnose early. An irritated brain can lead to such a wide array of symptoms. It is even more challenging when the initial symptoms seem to align with what we perceive as psychiatric concerns.
Paramedicine Now brings together the best content for paramedicine professionals from the widest variety of thought leaders.
Emergency Medicine Cases
JULY 30, 2024
In this month's EM Quick Hits podcast: Andrew Petrosoniak on the role of vasopressors in the hemorrhaging trauma patient, Megan Landes on providing HIV PEP and PrEP in the ED, Justin Morgenstern & George Kovacs on the PREOXI trial and evidence for pre-oxygenation with NIPPV before intubation in RSI, Brit Long on recognition and management of blast crisis in the ED, and Leah Flanagan & Liam Loughrey on the rise of nitrous oxide toxicity.
Core EM
JULY 23, 2024
The Case A 71-year-old male with a history of chronic obstructive pulmonary disease, hyperlipidemia, and peptic ulcer disease presents to the emergency department with substernal chest pain radiating down the right arm and dyspnea that began acutely while “running” up the stairs from the subway. The following ECG is obtained upon arrival to the emergency department.
The Skeptics' Guide to EM
JULY 6, 2024
Reference: Tjan et al. Conflict in emergency medicine: A systematic review. AEM June 2024 Date: July 5, 2024 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. She co-founded FOAMcast and is a pulmonary embolism and implementation science researcher.
EMergucate
JULY 30, 2024
The following ECG is from a 67-year-old man who presents with dizziness and fatigue. He has a past history of ischaemic heart disease, hypertension and hypercholesterolaemia.
Pediatric EM Morsels
JULY 5, 2024
It seems like just yesterday ( or maybe ~ a month ago ) when we served up a tasty morsel on the PECARN decision rule for intra-abdominal traumatic injuries in children. Our friends at the PECARN injury group have remained busy this spring with generating more externally validated clinical decision rules. In addition to the recently published low risk intra-abdominal injury validation, we have another new tool to use this summer as school breaks, underdeveloped frontal lobes, and high speeds leav
American Ambulance Association
JULY 23, 2024
Tamara Annette Robinson Moss Paramedic & Field Training Officer Richmond Ambulance Authority Richmond, VA Share on Facebook | LinkedIn | Instagram | X How did you come to be in […] The post EMS Profiles | Meet Tamara Moss appeared first on American Ambulance Association.
Emergency Medicine Cases
JULY 9, 2024
The decision of whether or not to order a CT head for an older patient who falls is one I need to make on almost every shift. The Canadian CT Head Rule does not apply to older patients. Does the recently derived Falls Decision Rule give us an answer to the question of which older patients can safely forego a CT head after a fall? Dr. Rohit Mohindra reviews the latest evidence in this EM Cases Journal Club.
Core EM
JULY 23, 2024
The Case An elderly male with a past medical history of hypertension and diabetes presents to the emergency department with a chief complaint of diarrhea and shortness of breath. His vital signs are: HR 60, BP 105/65, RR 30, O2 100% on room air, oral T 98.6 F, and FSG 120. EKG Show Details EKG Characteristics Rate 60 BPM Rhythm Regular, no discernible P-waves Intervals PR na; QRS complex > 160 ms; QT Prolonged Axis LAD ST Segments Wide QRS complexes slurring into very large pointed T waves Diagn
The Skeptics' Guide to EM
JULY 27, 2024
Reference: Knack et al. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Ann Emerg Med 2024 Date: July 25, 2024 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: Your hospital is running Morbidity and Mortality (M&M) rounds after a few recent cases in which the diagnosis of sepsis was identified late, and antibiotics were delayed.
EMergucate
JULY 1, 2024
Question 1: • Hb = 76 (between 7 and 9.9) = moderate anaemia. Normal MCH and MCV so we have normochromic anaemia. • WBC = 1.5 (N = 0.9) = mild leukopenia with moderate neutropenia.
Critical Care Scenarios
JULY 24, 2024
We discuss the practicalities of using airway pressure release ventilation (APRV) with Dr. Rory Spiegel (@EMnerd_), emergency physician and intensivist at MedStar Washington Hospital Center (and EMNerd at Emcrit). Find us on Patreon here! Buy your merch here! Takeaway lessons We discuss the practicalities of using airway pressure release ventilation (APRV) with Dr.
American Ambulance Association
JULY 31, 2024
Responding to Behavioral Health Emergencies Don’t Miss this Virtual Symposium, August 2, 2024 The EMS community is increasingly tasked with responding to behavioral health emergencies. The 988 suicide and crisis […] The post EMS.gov | Responding to Behavioral Health Emergencies appeared first on American Ambulance Association.
Emergency Medicine Cases
JULY 30, 2024
As a profession, we suck at compassion as it is trained out of us through medical school and beyond. Compassion in not simply innate; like any behaviour, it can be learned through deliberate practice. There is evidence that compassion may improve morbidity and/or mortality in patients after trauma, cardiac events, cancer, diabetes, back pain, migraine headache and other conditions, prevent physician burnout and reduces rates of medical error, reduce the rates of patient complaints and litigation
Core EM
JULY 23, 2024
Author: Mallika Singh, MD Editor: Jonathan Kobles, MD Background Unintentional or intentional exposure to radiological material represents a potential threat to human health on the individual to mass-casualty scale. Radioactive sources include medical isotopes, fuel rods, generators, and other industrial sources. Due to their availability, iridium-192, Cesium-137, and Cobalt-60 are often viewed as the substances posing the greatest threat for intentional radiation exposure.
St. Emlyn's
JULY 9, 2024
St.Emlyn's - Emergency Medicine #FOAMed A podcast with Steve Smith ECG educator extraordinaire where we discuss occlusive myocardial infarction and the future of AI and ECG interpretation. The post Podcast – Occlusive Myocardial Infarction, ECGs and Artificial Intelligence with Steve Smith appeared first on St.Emlyn's.
EMergucate
JULY 2, 2024
The forearm x-ray is from a child with pain & swelling in the elbow & forearm following a FOOSH injury. Only 1 view could be obtained due to patient being in distress. What can be seen?
REBEL EM
JULY 1, 2024
Background: Non-invasive positive pressure ventilation (NIPPV) is an effective treatment modality for patients with both hypoxemic or hypercapnic respiratory failure and has been shown to decrease the need for intubation [2]. Continuous positive airway pressure (CPAP) provides a constant positive pressure support throughout the breathing cycle, while bilevel positive airway pressure (BPAP) provides different levels of positive airway pressure during inspiration and expiration.
American Ambulance Association
JULY 31, 2024
Read Statement Authors: Douglas F. Kupas*, Matt Zavadsky, Brooke Burton, Chip Decker, Robert Dunne, Peter Dworsky, Richard Ferron, DanielGerard, Joseph Grover, Joseph House, Jeffrey Jarvis, Sheree Murphy, Jerry Overton, Michael […] The post Joint Position Statement on EMS Performance Measures Beyond Response Times appeared first on American Ambulance Association.
Emergency Medicine Cases
JULY 16, 2024
Registration is now open for the 2024 International EM Cases Summit November 21-23. Registration includes 3 days of talks, panel discussions, interactive discussions, procedural demos, an ebook and access to all the talks for 3 months after the conference. We also offer small group virtual simulation sessions, symposiums on EM Flow, Rural EM and Global EM plus a pre-conference HEARTS ECG course!
Core EM
JULY 23, 2024
We review Acute Respiratory Distress Syndrome Hosts: Sadakat Chowdhury, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Critical Care , Pulmonary Show Notes Definition of ARDS: Non-cardiogenic pulmonary edema characterized by acute respiratory failure. Berlin criteria for diagnosis include acute onset within 7 days, bilateral pulmonary infiltrates on imaging, not fully explained by cardiac failure or fluid overload, and impaired oxygenation with PaO2/FiO2 ratio <300 mmHg, even wi
Critical Care Scenarios
JULY 31, 2024
We share our grand new project, the Intensive Care Academy, an online, video-based, subscriber-only educational platform. Check it out at icu101.com! We share our grand new project, the Intensive Care Academy, an online, video-based, subscriber-only educational platform. Check it out at icu101.com !
EMergucate
JULY 9, 2024
The following ECG is from a 74-year-old man with one hour of chest pain. He has no cardiac risk factors and denies any significant medical history.
St. Emlyn's
JULY 14, 2024
St.Emlyn's - Emergency Medicine #FOAMed Background – What do we already know about REBOA? In 2023, Dr Zaf Qasim reviewed the UK REBOA trial for us on St Emlyn’s (The UK-REBOA trial – Has the […] The post JC: Prehospital Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Exsanguinating Subdiaphragmatic Hemorrhage appeared first on St.Emlyn's.
American Ambulance Association
JULY 26, 2024
Register Now: National EMS Advisory Council Meeting August 7-8, 2024 The National EMS Advisory Council (NEMSAC) will host a hybrid meeting on Wednesday, August 7, 2024, at 1:00 pm ET, […] The post National EMS Advisory Council Meeting August 7-8, 2024 appeared first on American Ambulance Association.
The Bottom Line
JULY 19, 2024
In critically ill patients undergoing tracheal intubation does pre-oxygenation with non-invasive ventilation compared with pre-oxygenation with an oxygen mask reduce the incidence of hypoxemia during intubation?
Core EM
JULY 23, 2024
High risk and low prevalence diseases: Blast injuries American Journal of Emergency Medicine, 2023 Background Blast injuries stem from the instantaneous transformation of a substance from solid or liquid to gas, releasing energy in the form of heat, light, pressure, and sound. While rare, blast injuries carry a high rate of morbidity and mortality. Blast injuries commonly have a mixed presentation of blunt and penetrating trauma.
NVFC
JULY 2, 2024
The National Volunteer Fire Council (NVFC) has received $100,000 from Tractor Supply Company, the largest rural lifestyle retailer in the United States, and the Tractor Supply Company Foundation. The donation comes as part of the retailer’s launch of its Hometown Heroes program and its $1 million donation to charity organizations supporting our nation’s military service members, veterans, and first responders.
EMergucate
JULY 9, 2024
75 year old lady presented to the emergency department after a fall. In ED she was found to be slightly febrile with blood pressure of 95/55.
St. Emlyn's
JULY 11, 2024
St.Emlyn's - Emergency Medicine #FOAMed The Faculty of Forensic & Legal Medicine's guidelines for managing non-fatal strangulation (NFS). These guidelines advocate a trauma-informed, multidisciplinary approach to improve outcomes for patients who have experienced NFS. @stemlyns #FOAMed The post Non-fatal strangulation appeared first on St.Emlyn's.
American Ambulance Association
JULY 26, 2024
This content is for AAA members only. Please either Log In or Join! The post RAND Corporation issues two reports on ground ambulance industry appeared first on American Ambulance Association.
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